Healthcare Provider Details

I. General information

NPI: 1245863547
Provider Name (Legal Business Name): SHERANDA HINES-HIGGINS RDA, NA, PT, HHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2020
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 CAROLINA FOREST BLVD APT 1C
JACKSONVILLE NC
28546-8053
US

IV. Provider business mailing address

326 CAROLINA FOREST BLVD APT 1C
JACKSONVILLE NC
28546-8053
US

V. Phone/Fax

Practice location:
  • Phone: 501-392-7821
  • Fax:
Mailing address:
  • Phone: 501-392-7821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number10308HHP
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number10308HHP
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code175M00000X
TaxonomyLay Midwife
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number10308HHP
License Number StateNC
# 5
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: